Dr. Hugh McLeanA Top Surgeon Specializing in

Top Surgery

FAQ

Contouring is an elective procedure that patient may choose to maximize the appearance of their chest.

Dr. McLean has always tried to make his patients chests look masculine. This involves techniques beyond what is necessary to remove the breasts (mastectomy).

Contouring may involve internal sutures to shape the chest. These sutures also prevent the need for drains. Contouring may also include modified incisions or incisions extended beyond those required for mastectomy to produce the best shape or avoid dog ears. It may involve alteration to the areas peripheral to the breast to blend the mastectomy and the rest of the chest. Liposuction may be a component of this.

The contouring fee also covers most revisions that may be needed later such as reduction of dog ears.

What is Top Surgery?

Gender is a topic that can generate a lot of confusion and a lot of discussion. Our clients may consider themselves transgender or may describe their gender in many other ways. Some are simply female. Some are genderless. No matter how they define their gender, there appears to be one constant theme: the female breast is unwanted. Their body image emphatically does not include the breast. This may be described by the general term, "breast dysphoria", avoiding the conundrum of “gender dysphoria”.

Top surgery is a cosmetic or reconstructive mastectomy and involves the surgical removal of the breasts in order to achieve a desired appearance. The aim is to make your chest look the way you want. FTM clients usually wish to masculinize their chest. It is important for you to let Dr. McLean know what is on your mind. He will discuss the options with you, discuss the limitations of treatment, and help you realize your wishes as effectively as possible.

Do I have to qualify for top surgery?

For us, the diagnosis of breast dysphoria is made by the patient, not the doctor, in the same way that a patient seeking breast enlargement is the one who diagnoses her own breasts as being too small. Therefore, the responsibility of the surgeon is to assure that the client is aware of the nature and purpose of the proposed procedure, its alternatives, limitations and potential consequences including risks and complications. This process is called "informed consent". When we are reasonably certain that your information is adequate to allow you to decide whether or not to have the surgery, then we can agree to do it for you.

Who Would Want Top Surgery or FTM Chest Surgery?

Chest masculinization is requested by those who find that feminine breasts do not suit their perception of themselves. If you are FTM, transgender, gender fluid, or identify elsewhere in the spectrum of those who are uncomfortable with their breasts, you may want to consider top surgery.

What Will Top Surgery Do For Me?

Top surgery is designed to remove the breasts and create a masculine appearing chest. Whether it is a "double incision", "keyhole" or "periareolar" procedure the aim is the same: to help your body conform to your self-image. No procedure is able to assure that sensation is retained and the main difference in the procedures is the amount of scarring. People who have top surgery often say that they are finally able to get on with their lives, that they now appear the way they should, and that they are more confident in their role in life.

How Easy is Having Top Surgery?

The McLean Clinic’s philosophy is that the achievement of personal goals should not be hampered by artificial barriers. Whether you want breast implants, breast reduction or chest masculinization, we try to make it easy. You are not required to be taking testosterone, for example. We use an informed consent process to qualify you for surgery. The procedure is performed in the privacy of our Mississauga cosmetic clinic and you are asleep. Our doctors and nurses have cared for hundreds of people who have had this surgery and are totally familiar with your needs. We do not use drains or tubes for the double incision procedure. We follow your progress carefully. If you have nipple graft dressings, they are removed after a minimum of eight days. You may bathe or shower, as long as the graft dressings are kept dry. We will supply you with the materials you need for dressings, and show you a simple way to use them.

Is There Any Downside to FTM top Surgery?

All surgery has potential risks such as infection, bleeding, healing problems and adverse scars. A mastectomy is irreversible: a normal breast can never be restored. No procedure can guarantee retention of nipple sensation. Scars are permanent.

How Can I Make My Top Surgery Even Better?

Those who want a masculine appearance may choose to combine other procedures with top surgery. Liposuction, for example, can remove some unwanted curves.

When will I be back to normal?

Generally speaking, most clients are back to full activities within 6 weeks.

Day 1 should be restful with limited activity although we encourage walking.

During the first week, some activities may be resumed such as light housekeeping and preparing meals but with no heavy lifting or stretching.

After the grafts are taken down (after 8+ days) or the drains (for keyhole procedure) are removed clients may consider returning to sedentary work but should limit their physical activity.

After 2 weeks, most clients may return to the gym to do moderate lower body exercise but no full exertion.

After 4 weeks, most clients are back on the treadmill or elliptical units but still avoiding full exertion.

After 6 weeks, most clients are back to full activities but listen to your body! Pain is a very good indicator to stop certain activity.

It takes about 3-6 months for most of the swelling to go down and about a full year for scars to mature.

During the first year it is important to take care of your scars to achieve optimal healing. You can do this by keeping them out of the sun and by using our Skinmedica Scar Recovery Gel.

Am I a candidate for FTM top surgery?

In order to proceed with the FTM top surgery, you must be in good physical and mental health. Although we do not require psychiatric evaluations, you must have a complete physical examination done by your family doctor and have routine blood work prior to having FTM top surgery.

We do not discriminate against smokers although it is highly recommended that you quit or at least cut back prior to your surgery. Smoking may delay healing or cause other complications.

Please advise us of all medications that you may be taking including vitamins, herbs and dietary supplements. Most medications including testosterone do not interfere with FTM top surgery and may be taken right up until your surgery. We do recommend that you avoid Vitamin E, ASA, or ibuprofen products at least 2 weeks prior to FTM top surgery unless they have been prescribed by a doctor. If you have any allergies to anything (not just medication), please let us know.

Please inform us of any medical conditions or recent surgeries that you may have had to help us optimize your surgical experience. All breast tissue removed during FTM top surgery is sent to a lab for pathology which takes approximately 2 weeks for the results. These results will be available to you as well as copies to your family doctor.

For more information, call 1-866-766-9280.

What Does FTM Top Surgery Cost?

The cost of top surgery is $8000 CAD + applicable taxes.

What does my $8000 get me???

This amount includes:

the initial consultation

all pre and post instructions

the pre-operative visit

the actual surgery

general anesthesia

all facility fees

pathology fees

after hours support 24/7

all post-operative visits

surgical binder and dressing supplies

How do I pay??

A 10% deposit is required to reserve your surgical date. The remaining balance is due 2 weeks prior to this day. We do not provide financing, however, we do assist with obtaining financing through the widely respected finance companies, Crelogix and Medicard. The rates for financing your FTM top surgery are usually more reasonable than using a credit card although some patients prefer to go to their own bank and apply for a line of credit.

After your consultation with Dr. McLean, we will provide you with a surgical quote that you can take to your own finance company or we can also assist you to use ours.